Description

Job title

Credentialing Coordinator

#FPCN-CRCOOR-04262024

Program Summary

The Family Practice & Counseling Network (FPCN) provides comprehensive primary care, dental and behavioral health services. We stand behind the belief that all people are entitled to accessible, comprehensive, quality, and affordable health care, and that care must be delivered in a culturally competent, trauma-informed and compassionate manner by caring for the whole person - mind, body & spirit. The network's mission is to provide person-centered, integrated and comprehensive health services to individuals and families across their lifespan. The network promotes resiliency and well-being among patients, staff and surrounding communities.

The Network consists of three (3) federally qualified health centers (FQHC) in Philadelphia:

• Abbottsford Falls Family Practice & Counseling (Northwest Philly);
• Stephen & Sandra Sheller 11th Street Family Health Services of Drexel University (North Philly); and
• Health Annex (Southwest Philly).

Today the FPCN serves more than 20,000 patients annually and is a NCQA certified Patient-Centered Medical Home and recognized by HRSA as a National Quality Leader for Behavioral Health.

Position Summary

The Credentialing Coordinator is responsible for all aspects of the privileging and credentialing process for all FPCN providers. The Coordinator will processes applications, verify information, research application details, and assure processes are in accordance with NCQA standards and applicable laws. The Coordinator will provide consistent, accurate, and timely credentialing support, enhancing the Network's ability to provide healthcare services. In addition, the Credentialing Coordinator will provide general human resources assistance and uphold the mission and beliefs of the organization by working with the Billing team to ensure that all requirements are met for credentialing and enrollment for staff.

Essential Duties and Functions

• Perform accurate, timely and documented verification of the information provided by the provider and maintenance of the highly confidential credentialing related files.
• Create and facilitate completion of clinician applications for payers.
• Facilities to ensure timely credentialing and enrollment.
• Process credentialing and re-credentialing applications of licensed staff including: Non-billable supportive medical staff and Billable medical providers.
• Maintains compliance with documentation standards for verification of employee credentialing requirements, including but not limited to licenses, certifications, registrations, permits, educational degrees, association memberships.
• Tracks and maintains copies of current credentialing documents and performs primary verifications and ensures:
• State licenses, certificates, malpractice coverage, and other required credentialing documents in confidential provider files.
• Update CAQH database with quarterly attestations, updating credentialing documents as needed/required
• Enters providers' credentials and privileging data into the credentialing database
• Tracks and maintains Medicare exclusion checks for entire staff.
• Other responsibilities as assigned.

Qualifications

• Bachelors Degree (BS/BA), plus 1 year Healthcare credentialing experience OR Associates Degree (AS/AA), plus 3 years Healthcare credentialing experience.
• Certified Professional Credentialing Coordinator (CPCC); Certified Provider Credentialing Coordinator (CPCS); or Certified Medical Staff Coordinator (CMCS) by the National Association of Medical Staff Services (NAMSS) preferred
• Knowledge of provider credentialing criteria and processes in accordance with NCQA.
• Knowledge of NPDB guidelines and general licensing regulations.
• Familiarity with community health centers that have both medical and dental practices, preferably in a FQHC.
• Professional and effective oral and written communication skills.
• Ability to manage workload priorities to meet critical deadlines.
• Proficient in Microsoft Office Suites, Video Conference/Collaboration Tools, along with proprietary database applications.
• Ability to work professionally, independently and/or collaboratively as needed.
• Maintains knowledge of standards of the Health Resources and Services Administration, Federal Tort Claims Act (FTCA), NCQA, federal and state regulations, and other organizations as applicable.

Requirements

Resources for Human Development is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, age, religion, gender, gender identity, sexual orientation, national origin, genetic information, veteran, or disability status.

Covid-19 Vaccine Mandate: FPCN, a program in the City of Philadelphia, are required to follow the COVID vaccine mandate for healthcare workers per Philadelphia Department of Public Health. FPCN requires Healthcare Workers to be fully vaccinated. Fully vaccinated means it has been two weeks since the final dose of vaccine. Thus, we require vaccination prior to start for all new hires. This currently does not include boosters.